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Santos-Guzmán A, Unar-Munguía M, Rivera JA, Ramírez-Silva I. Addressing infant and young child feeding recommendations from a planetary health perspective. Adv Nutr 2024:100303. [PMID: 39278466 DOI: 10.1016/j.advnut.2024.100303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Revised: 08/21/2024] [Accepted: 09/10/2024] [Indexed: 09/18/2024] Open
Abstract
Current international infant and young child (IYC) feeding recommendations consider nutrition and health but not environmental impacts. Only a handful of countries have dietary guidelines that provide quantitative recommendations for food groups of environmental concern. OBJECTIVE To perform a narrative review of the environmental impacts of commercial milk formula vs. breastfeeding, and to analyze the degree to which current country-specific IYC feeding recommendations are aligned with sustainable dietary targets. METHODS A mixed methods review was conducted, including : a) a narrative review of the environmental impact of commercial milk formula compared with breastfeeding, and b) a comparison of recommended intake of meats and dairy for children IYC based on country-specific dietary guidelines vs. the Eat-Lancet Commission dietary targets (ELCT) for children 24 months or older and adults and if the ELCT should be adjusted for the energy needs of IYC. RESULTS Formula feeding has a greater environmental impact (∼48% higher carbon footprint) compared to exclusive breastfeeding. Available country-specific dietary guidelines for meat and dairy products in children IYC are, in general, at or below the upper limits of the ELCT recommended ranges for older children and adults but are in most cases above the upper limit when adjusting for the energy needs of IYC. CONCLUSIONS Exclusive breastfeeding should be protected and promoted not only as the healthier but also as the most sustainable alternative. Available complementary dietary feeding recommendations of non-processed meat and dairy fall below current ELCT for older children and adults. Given that IYC requiere a more nutrient-dense diet than older children and adults, and considering the small quantities they consume, we recommend using the unadjusted ELCT as reference for IYC feeding while specific international consumption recommendations are developed for this age group.
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Affiliation(s)
- Andrea Santos-Guzmán
- Center for Health and Nutrition Research, National Instituto of Public Health, Cuernavaca, Morelos Mexico
| | - Mishel Unar-Munguía
- Center for Health and Nutrition Research, National Instituto of Public Health, Cuernavaca, Morelos Mexico
| | - Juan A Rivera
- Center for Research in Population Health, National Institute of Public Health, Cuernavaca, Morelos.
| | - Ivonne Ramírez-Silva
- Center for Health and Nutrition Research, National Instituto of Public Health, Cuernavaca, Morelos Mexico
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Tissue MM, Donney JF, Mullenix A, Schaffer K, Stampfel C, Ramos LR, Cilenti D. The Maternal and Child Health Workforce: A Snapshot of Current and Future Needs From Public Health WINS 2021. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024:00124784-990000000-00358. [PMID: 39265166 DOI: 10.1097/phh.0000000000002020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2024]
Abstract
OBJECTIVE To summarize and examine data collected from the first-ever Public Health Workforce Interests and Needs Survey Maternal and Child Health (MCH) module. DESIGN, SETTING, AND PARTICIPANTS Responses from MCH governmental public health employees in 47 state health departments and 288 local health departments (LHDs) in the United States. MAIN OUTCOME MEASURE Demographic characteristics; 4 measures from the MCH module: the importance of and skill level in 5 MCH competencies in daily work, growth and leadership development opportunities, and additional workforce development needs. RESULTS The MCH workforce predominantly self-identified as women (91.2%) and as White, non-Hispanic (55.2%). At least 70% of respondents reported MCH competencies as important in their daily work, but only 44% to 57% reported being proficient in those competencies. The MCH workforce in LHDs were less likely than those in state health departments to report being proficient in MCH competencies (adjusted prevalence rate ratio range: 0.83-0.92) or have growth and leadership development opportunities (adjusted prevalence rate ratio range 0.76-0.90). CONCLUSION The MCH module highlights a need to further prioritize workforce development efforts for governmental public health staff, especially in LHDs. There is an ongoing need to meet public health professionals where they are and to tailor training models and workforce development plans to account for new and ongoing stressors faced by the workforce.
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Affiliation(s)
- Michelle Menser Tissue
- Author Affiliations: Maternal and Child Health Bureau, Health Resources and Services Administration, US Department of Health and Human Services, Rockville, Maryland (Ms Tissue and Dr Donney); Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (Ms Mullenix, Ms Ramos and Dr Cilenti); Strategic Impact, Association of Maternal and Child Health Programs, Washington, District of Columbia (Ms Stampfel); and Research, Evaluation, and Learning, de Beaumont Foundation, Bethesda, Maryland (Ms Schaffer)
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Patrick SW, Loch SF, McNeer E, Davis MM. Voter Support for Policies Associated With Child Health as National Campaign Priorities. JAMA HEALTH FORUM 2024; 5:e243305. [PMID: 39331370 PMCID: PMC11437383 DOI: 10.1001/jamahealthforum.2024.3305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/28/2024] Open
Abstract
Importance Policies that are associated with child health are rarely included in platforms of candidates for national political office. Candidates may underrecognize voter support for such priorities or perceive that such policy issues are not sufficiently divisive to appeal to partisan voters. Key policy questions associated with child health may be considered by the next Congress, including the consistency of Medicaid coverage across states and restoring the recently lapsed refundable child tax credit. Objective To examine voter support for candidates regarding policies that are associated with child health. Design, Setting, and Participants This nationally representative survey of registered US voters 18 years or older was conducted from March to April 2024 and included a survey-based randomized experiment to evaluate the association of message framing with voter support. Exposures Messages conveying distinct rationales for Medicaid reform and refundable child tax credit. Main Outcomes and Measures Likely or definite support for candidates. Results In this sample (unweighted N = 2014; 1015 women [51.0%]), most respondents indicated they would likely or definitely vote for candidates who expressed strong support for all tested policies: extreme risk protection order (79.5%), school threat assessment (73.1%), expanded childcare (69.6%), refundable child tax credit (66.6%), federalization of Medicaid (66.0%), paid parental leave (65.5%), free school meals (65.6%), safe firearm storage and enforcement (62.9%), preventing Medicaid disenrollment for children younger than 6 years (61.9%), universal free preschool (61.6%), and summer nutrition programs (57.9%). More women than men expressed support for all tested policies. Strong majorities of Democrat and Independent voters would support candidates who endorsed child-focused policies; fewer than 50% of Republican voters expressed such support, except for the extreme risk protection order and school threat assessment. Variations in framing language regarding consistent Medicaid coverage across states were not associated with amplified or diminished voter support. Framing the refundable child tax credit as benefiting "hard-working" vs "low-income" families garnered significantly more support among men (67.0% vs 59.0%), privately insured individuals (72.0% vs 64.4%), and Republicans (54.6% vs 43.0%; all P < .05). Conclusions and Relevance The study results suggest that most voters favor candidates who strongly support policies that are associated with child health. Voter support differs substantively by gender and political party affiliation and may be associated with language choices in messaging about policy change.
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Affiliation(s)
- Stephen W Patrick
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Emory University, Atlanta, Georgia
| | - Sarah F Loch
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Elizabeth McNeer
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee
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Keefe-Oates B, Janiak E, Gottlieb B, Chen JT. Disparities in Postpartum Care Visits: The Dynamics of Parental Leave Duration and Postpartum Care Attendance. Matern Child Health J 2024; 28:1506-1516. [PMID: 38795280 PMCID: PMC11358175 DOI: 10.1007/s10995-024-03929-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 05/27/2024]
Abstract
OBJECTIVES To understand differences in the relationship between parental leave duration and postpartum care across sociodemographic and income groups. METHODS We used data from six states participating in the Center for Disease Control and Prevention's yearly PRAMS study from 2016 to 2019 with a total sample of 12,442 people. Bivariable analyses assessed demographics among those who took more or less parental leave and estimated the prevalence of not accessing postpartum care by demographics, stratified by leave length. We used propensity score weighting to estimate the predicted risk and risk ratios of not accessing postpartum care with < 7 as compared to > = 7 weeks of leave, stratified by income. RESULTS There were significant differences in the prevalence of not accessing care stratified by leave duration, and disparities in utilization by race, ethnicity, and income. A shorter leave duration was associated with a higher risk of not accessing care (RR: 1.98 [CI 1.25-3.20] in higher income group, RR: 1.45 [CI 1.08, 1.99] in lower). The absolute risk of not accessing care was highest in the lower income group regardless of leave duration, though patterns of increased utilization with longer leave duration were consistent in both groups. CONCLUSIONS FOR PRACTICE While shorter leave durations increased the risk of not attending postpartum care, those with lower incomes had the highest absolute risk of not attending care. Policies to support paid leave and extended leave duration are necessary, along with additional supports to increase postpartum care utilization, particularly among low-income families.
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Affiliation(s)
- Brianna Keefe-Oates
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA.
| | - Elizabeth Janiak
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Barbara Gottlieb
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA, USA
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Fischer AR, Doudell KR, Cundiff JM, Green SRM, Lavender CA, Gunn HE. Maternal Sleep Health, Social Support, and Distress: A Mixed-Methods Analysis of Mothers of Infants and Young Children in Rural US. Behav Sleep Med 2024; 22:650-673. [PMID: 38600856 DOI: 10.1080/15402002.2024.2339818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
OBJECTIVES The purpose of this study was to explore sleep health in rural maternal populations through a social-ecological framework and identify risk and protective factors for this population. METHODS 39 individuals who are mothers of infants or children under the age of 5 years completed an online survey, 35 of which completed a subsequent semi-structured interview. Recruitment was limited to one rural community and was in partnership with community healthcare providers. Results were integrated using a convergent, parallel mixed-methods design. RESULTS Poor sleep health and high prevalence of insomnia symptoms in rural mothers were evident and associated with social support and maternal distress. Qualitative content from interviews indicated that well-established precipitating and perpetuating factors for insomnia may contribute to poor maternal sleep health. Results also revealed a gap in knowledge and language surrounding sleep health among rural mothers. CONCLUSIONS Sleep health is challenged during the transition to motherhood and rural mothers have less access to specialized perinatal and behavioral health care than their urban counterparts. In this sample, poor sleep was attributable to distress in addition to nocturnal infant and child sleep patterns which has implications for psychoeducation and promotion of sleep health in mothers. Sleep is a modifiable health indicator that is associated with several other maternal health outcomes and should be considered an element of a comprehensive maternal health for prevention and intervention across individual, interpersonal, and societal domains of the social-ecological model of sleep health.
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Affiliation(s)
| | - Kelly R Doudell
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Jenny M Cundiff
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | | | - Catherine A Lavender
- College of Community Health Sciences, University of Alabama, Tuscaloosa, AL, USA
| | - Heather E Gunn
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
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Ahrens KA, Janevic T, Strumpf EC, Nandi A, Ortiz JR, Hutcheon JA. Paid Family Leave and Prevention of Acute Respiratory Infections in Young Infants. JAMA Pediatr 2024:2822790. [PMID: 39186259 PMCID: PMC11348083 DOI: 10.1001/jamapediatrics.2024.3184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/26/2024] [Indexed: 08/27/2024]
Abstract
Importance Acute respiratory tract infections are the leading cause of emergency department visits and hospitalizations in US children, with highest risks in the first 2 months after birth. Out-of-home childcare settings increase the spread of respiratory tract infections. The study team hypothesized that access to state-paid family leave could reduce acute care encounters (hospital admissions or emergency department visits) for respiratory tract infections in young infants by reducing out-of-home childcare transmissions. Objective To determine if the 2018 introduction of paid family leave in New York state reduced acute care encounters for respiratory tract infections in infants 8 weeks or younger. Design, Setting, and Participants This population-based study of acute care encounters took place in New York state and New England control states (Maine, Massachusetts, New Hampshire, Vermont) from October 2015 through February 2020. Participants included infants aged 8 weeks or younger. Controlled time series analysis using Poisson regression was used to estimate the impact of paid family leave on acute care encounters for respiratory tract infections, comparing observed counts during respiratory virus season (October through March) with those predicted in the absence of the policy. Acute care encounters for respiratory tract infections in 1-year-olds (who would not be expected to benefit as directly from the policy) were modeled as a placebo test. Intervention New York State Paid Family Leave policy, introduced on January 1, 2018, providing 8 weeks of paid leave for eligible parents. Main Outcomes and Measures Emergency department visits or hospitalizations with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD) codes for upper or lower respiratory tract infections or associated symptoms (ie, fever, cough), excluding newborn hospitalizations. The secondary outcome was acute care encounters for respiratory syncytial virus (RSV) bronchiolitis. Results There were 52 943 acute care encounters for respiratory infection among infants 8 weeks or younger. There were 15 932 encounters that were hospitalizations (30%) and 33 304 of the encounters were paid for by Medicaid (63%). Encounters were 18% lower than predicted (relative percentage change = -17.9; 95% CI, -20.3 to -15.7) after the introduction of paid family leave. RSV encounters were 27.0% lower (95% CI, -30.9 to -23.5) than predicted. Similar reductions were not observed in 1-year-olds (relative percentage change = -1.5; 95% CI, -2.5 to -0.6). Conclusions New York state's paid family leave policy was associated with reduced acute care encounters for respiratory tract infections in young infants. These findings may be useful for informing implementation of paid family leave federally and in the states that have not enacted paid family leave policies.
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Affiliation(s)
- Katherine A. Ahrens
- Muskie School of Public Service, University of Southern Maine, Portland, Maine
| | - Teresa Janevic
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Erin C. Strumpf
- Department of Economics and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Arijit Nandi
- Department of Equity, Ethics, and Policy and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Justin R. Ortiz
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jennifer A. Hutcheon
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
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von Fedak S, Priven S, Khalid A, Brooks A, Lund GC. Parental Leave: What Do Physician Societies Provide for Their Employees? WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:588-593. [PMID: 39183769 PMCID: PMC11342047 DOI: 10.1089/whr.2024.0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/18/2024] [Indexed: 08/27/2024]
Abstract
Introduction Parental leave yields significant health benefits for parents and children. While many medical associations endorse parental leave, it is unknown what parental leave they provide for their employees. Objective To assess parental leave policies of national physician societies for their employees including paid versus unpaid and parity between birth mothers and non-birthing parents. Methods and Materials A cross-sectional analysis in 2023 examined parental leave policies of national physician societies, including the American Medical Association (AMA), American Osteopathic Association (AOA), and six specialty societies: American College of Obstetricians and Gynecologists (ACOG), American College of Osteopathic Obstetricians and Gynecologists (ACOOG), American Academy of Pediatrics (AAP), American College of Osteopathic Pediatricians (ACOP), American Academy of Family Physicians (AAFP), and American College of Osteopathic Family Physicians (ACOFP). Examination of policies included: duration, whether paid or unpaid; qualifications before receiving benefit; and whether non-birthing, adoptive, and foster parents were covered. Results Among the eight societies surveyed, two (25%) did not disclose their policies (ACOG, ACOP), and one (12.5%) lacked a policy (ACOOG). Of the remaining five, two (40%) offered paid leave (AMA, AAP), while three (60%) provided unpaid leave in line with legal requirements (AOA, AAFP, ACOFP). Benefits for non-birthing parents mirrored those for birth mothers, although the AMA offered birth mothers enhanced benefits. Conclusions Only a minority of surveyed physician societies provide paid parental leave. Physician societies should consider providing paid parental leave for their employees and making their policies publicly available to promote and model the benefit of paid parental leave.
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Affiliation(s)
- Sofia von Fedak
- University of New England College of Osteopathic Medicine, Biddeford, Maine, USA
| | - Sonya Priven
- Rowan-Virtua School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Amna Khalid
- Rocky Vista University College of Osteopathic Medicine, Parker, Colorado, USA
| | - Amanda Brooks
- Rocky Vista University College of Osteopathic Medicine, Parker, Colorado, USA
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Chin HB, Howards PP, Kramer MR, Johnson CY. Understanding the roles of state demographics and state policies in epidemiologic studies of maternal-child health disparities. Am J Epidemiol 2024; 193:819-826. [PMID: 38055631 DOI: 10.1093/aje/kwad240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 11/20/2023] [Accepted: 12/04/2023] [Indexed: 12/08/2023] Open
Abstract
Disparities in maternal-child health outcomes by race and ethnicity highlight structural differences in the opportunity for optimal health in the United States. Examples of these differences include access to state-level social policies that promote maternal-child health. States vary in their racial and ethnic composition as a result of the complex history of policies and laws related to slavery, Indigenous genocide and relocation, segregation, immigration, and settlement in the United States. States also vary in the social policies they enact. As a result, correlations exist between the demographic makeup of a state's population and the presence or absence of social policies in that state. These correlations become a mechanism by which racial and ethnic disparities in maternal-child health outcomes can operate. In this commentary, we use the example of 3 labor-related policies actively under consideration at state and federal levels (paid parental leave, paid sick leave, and reasonable accommodations during pregnancy) to demonstrate how correlations between state demographics and presence of these state policies could cause or exacerbate racial and ethnic disparities in maternal-child health outcomes. We conclude with a call for researchers to consider how the geographic distribution of racialized populations and state policies could contribute to maternal-child health disparities.
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Affiliation(s)
- Helen B Chin
- Department of Global and Community Health, College of Public Health, George Mason University, Fairfax, VA 22030, United States
| | - Penelope P Howards
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
| | - Michael R Kramer
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, United States
| | - Candice Y Johnson
- Department of Family Medicine and Community Health, School of Medicine, Duke University, Durham, NC 27705, United States
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Tanis JM, Klein SM, Boyke H. State paid family leave policies and infant maltreatment. CHILD ABUSE & NEGLECT 2024; 152:106758. [PMID: 38574603 DOI: 10.1016/j.chiabu.2024.106758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Growing research points to economic policies as protective mechanisms for vulnerable families. Research on pediatric abusive head trauma suggests that paid family leave (PFL) may protect infants in the general population from physical abuse. OBJECTIVE To examine the association of state-level paid family leave policies with infant (ages 0-1) maltreatment rates. PARTICIPANTS AND SETTING A state-level panel dataset was constructed from the National Child Abuse and Neglect Data System (2002-2019) data on infant maltreatment investigations among four states with PFL (California, New Jersey, New York, and Rhode Island) and 36 states without PFL. METHODS A piecewise longitudinal model and a nested model comparison were conducted to estimate the treatment effect of PFL on the population rate of infant maltreatment investigations. Supplementary analyses examined the moderating effect of three covariates. RESULT PFL reduced the linear rate of change in infant maltreatment rates in the states where it was enacted by a factor of 0.979 for each year post-policy implementation compared to states without such policies, B = -0.021, SE = 0.008, 95 % CI = [-0.036,-0.005]. Examining treatment states only, the slope of infant maltreatment became significantly shallower post-policy implementation, χ2(1) = 3.178, p = .075. Interactions testing the moderating effects of family poverty and adults with less than high school education were significant, B = -0.304, 95 % CI = [-0.564,-0.052]; B = -0.511, 95 % CI = [-0.799,-0.249], respectively. CONCLUSION Results suggest that PFL has a beneficial effect on infant maltreatment rates and add to growing evidence that policies aimed to support household economic stability could be a vital child maltreatment prevention policy tool.
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Affiliation(s)
- Jennifer M Tanis
- Michigan State University, School of Social Work, 239 Baker Hall, East Lansing, MI 48824, United States of America; Hope College, Department of Sociology and Social Work, 41 Graves Place, PO Box 9000, Holland, MI 49422, United States of America.
| | - Sacha M Klein
- Michigan State University, School of Social Work, 239 Baker Hall, East Lansing, MI 48824, United States of America.
| | - Hannah Boyke
- Michigan State University, School of Social Work, 239 Baker Hall, East Lansing, MI 48824, United States of America.
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Morrissey TW, Castleberry NM, Soni A. The Impacts of New York State's Paid Family Leave Policy on Parents' Sleep and Exercise. Matern Child Health J 2024; 28:1042-1051. [PMID: 38294605 DOI: 10.1007/s10995-024-03899-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVES To assess changes in young parents' health behaviors following implementation of New York State's Paid Family Leave Program (NYSPFL). METHODS We used synthetic control (N = 117,552) and difference-in-differences (N = 18,973) models with data from the nationally representative Behavioral Risk Factor Surveillance System (BRFSS) from 2011 to 2019 to provide individual-level estimates of the effects of NYSPFL on self-reported exercise in the past month and average daily sleep of adults aged 21-30 years living with one or more children under 18 years of age in New York and comparison states. RESULTS Synthetic control model results indicate that the NYSPFL increased the likelihood of exercise in the past month among mothers, single parents, and low-income parents by 6.3-10.3% points (pp), whereas fathers showed a decrease in exercise (7.8 pp). Fathers, single parents, and those with two or more children showed increases in daily sleep between 14 and 21 min per day. CONCLUSIONS FOR PRACTICE State paid family and medical leave laws may provide benefits for health behaviors among young parents with children under 18, particularly those in low-income and single-parent households.
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Affiliation(s)
- Taryn W Morrissey
- Department of Public Administration and Policy, School of Public Affairs, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA.
| | - Neko Michelle Castleberry
- Department of Public Administration and Policy, School of Public Affairs, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - Aparna Soni
- Department of Public Administration and Policy, School of Public Affairs, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
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Rheinheimer N, Vacaru SV, van Immerseel JC, Kühn S, de Weerth C. Infant Care: Predictors of Outdoor Walking, Infant Carrying and Infant Outdoor Sleeping. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:694. [PMID: 38928940 PMCID: PMC11203610 DOI: 10.3390/ijerph21060694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Revised: 05/19/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND Although spending time outdoors is beneficial for development, little is known about outdoor time during infancy. The aim of this study was to assess frequencies and durations of (1a) outdoor walking and carrying in mother-infant dyads and (1b) infant outdoor sleeping in a stationary cot or pram. We furthermore aimed to identify associations of (2a) outdoor walking and carrying and (2b) infant outdoor sleeping, with infant, maternal and environmental sample characteristics. METHODS An online survey was distributed among mothers of 0- to 12-month-old infants. Initially, 1453 mothers were recruited, of which 1275 were included in the analyses. With respect to (1a) the outcomes of interest were: mother-infant dyads' total weekly duration of walking in minutes, frequency of walking on weekdays, as well as weekends, and the frequency of using an infant carrier during walks, as well as the daily duration of carrying in hours (indoors and outdoors together). With respect to (1b) the outcome variables were: placing the infant outdoors to sleep (yes/no), the total weekly duration of outdoor sleeping and the weekly frequency of outdoor sleeping. For aim 2, associations of the outcome variables with infant (i.e., age), maternal (i.e., working status) and environmental (i.e., house type) sample characteristics were assessed. RESULTS Mother-infant dyads engaged in walks for a total weekly duration of 201 min, for approximately one to three walks over weekdays (Monday through Friday), as well as one to three walks on the weekend. The infant carrier was used by 22% of mothers at least half of the time during outdoor walks, and 18% reported a daily duration of infant carrying of one hour or more. Among other associations, infant and maternal enjoyment of outdoor walking correlated positively with the duration as well as the frequency of walking during weekdays and during the weekend. Furthermore, employed mothers walked for a shorter duration and less frequently on weekdays as compared to mothers on maternity leave or mothers without a paid job. The availability of nearby recreational areas correlated positively with the weekly duration and frequency of walks. The infant carrier was used more frequently during outdoor walks if more than one child lived in the household. Infant carrying during outdoor walks was also related to infant behavior at night. Roughly a third of the mothers (29%) regularly had their infant sleep outdoors for a weekly duration of four hours and a weekly frequency of approximately one to two times. Younger infants, infants of mothers with higher education and infants living in detached houses were more likely to be placed outdoors to sleep. DISCUSSION We identified associations of infant, maternal and environmental characteristics with outdoor time spent during infancy. These results lay the foundation for future research on the effects of the outdoors on child development as well as on facilitators and barriers for caregivers.
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Affiliation(s)
- Nicole Rheinheimer
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Stefania V. Vacaru
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Department of Psychology, New York University-Abu Dhabi, Abu Dhabi P.O. Box 129188, United Arab Emirates
- Department of Clinical Child and Family Studies & Amsterdam Public Health, Vrije Universiteit Amsterdam, 1081 HV Amsterdam, The Netherlands
| | - Julie C. van Immerseel
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Simone Kühn
- Center for Environmental Neuroscience, Max Planck Institute for Human Development, 14195 Berlin, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, 20249 Hamburg, Germany
| | - Carolina de Weerth
- Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
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Nestander M, Day C, Lucke A, Gautam S, Horowitz E, Bernstein SM, Bhatia A. Workforce Characteristics of Early Career Neonatologists and Comparison of Practice Sites. Am J Perinatol 2024; 41:e1126-e1134. [PMID: 36649732 DOI: 10.1055/s-0042-1760430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Transitioning into the early career physician workforce is a uniquely challenging period in a neonatologist's career. There are limited educational opportunities in fellowship regarding career progression, practice models, and benefits. Understanding these factors are key when searching for employment. This study evaluates the early career neonatologist (ECN) workforce and employment characteristics to improve identification of professional needs. STUDY DESIGN An anonymous 59-question cross-sectional survey was distributed in July 2020 to members of the American Academy of Pediatrics Section on Neonatal Perinatal Medicine Trainees and Early Career Neonatologists (TECaN). The survey instrument was designed using SurveyMonkey and assessed search methods for identifying employers, employment contract details, and professional duties. Questions addressed clinical service time, level of acuity, protected research time, financial compensation, benefits, job search methods, and promotion requirements. Comparisons were drawn between respondents exclusively working in a university-based setting and respondents employed in nonuniversity locations. Responses were collected using SurveyMonkey and then extracted to a Microsoft Excel Workbook for analysis. Statistical analysis was performed using SAS version 9.4. RESULTS Of 1,302 eligible members, 348 people responded (26.7%). Forty-six percent of respondents worked in a university setting and 54% worked in a nonuniversity setting. Using employment site as a discriminator, significant differences were noted in scheduling models. University-located respondents were more likely to work 2-week block schedules, fewer weekend/weeknight call, less clinical weeks per year, and more research/administrative weeks per year. Between university and nonuniversity located positions, benefits were largely comparable, while factors perceived as influential toward promotion varied depending on practice site. CONCLUSION This study provides ECNs with a contemporary workforce description vital to graduating TECaN seeking employment or renegotiating professional obligations. While benefits were largely similar based on practice site, promotion factors and scheduling models may vary depending on location. KEY POINTS · Data specific to informing employment decisions for graduating Trainees and Early Career Neonatologists are limited.. · This study provides benchmarks for evaluating employment opportunities presented to early career neonatologists.. · Practice site can influence promotion factors..
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Affiliation(s)
- Matt Nestander
- Division of Newborn Medicine, Carl R. Darnall Army Medical Center, Fort Hood, Texas
| | - Colby Day
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Ashley Lucke
- Department of Pediatrics, Dell Children's Medical Center, Austin, Texas
| | - Shiva Gautam
- Department of Biostatistics, University of Florida, Jacksonville, Florida
| | - Eric Horowitz
- Division of Neonatology, Boston Children's Hospital, Boston, Massachusetts
| | - Sarah M Bernstein
- Division of Neonatology, The University of Utah, Salt Lake City, Utah
| | - Anisha Bhatia
- Division of Neonatology, Rush University Medical Center, Chicago, Illinois
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Herrick MSR, Chai W. Incidence of Postpartum Depression Decreases After Initial Expansion of Military Maternity Leave. Mil Med 2024; 189:e773-e780. [PMID: 37703065 DOI: 10.1093/milmed/usad354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/04/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION Postpartum depression impacts 1 in 8 women in the United States. Research has indicated maternity leave duration, and compensation can have an impact on postpartum depression symptoms. The U.S. military increased their maternity leave provision from 6 to 12 weeks in 2016. The aim of this study was to expand upon current literature on the role of maternity leave on postpartum depression by analyzing objective data from 2011 to 2019 utilizing military health records. METHODS All deliveries to active duty women in the Military Health System from 2011 to 2019 were considered for analysis. A total of 60,746 women met inclusion criteria. Active duty women were stratified by year of delivery to identify if they had 6 weeks (2011-2015) or 12 weeks (2016-2019) of maternity leave. International Classification of Disease (ICD)-9 and ICD-10 codes were used for the identification of postpartum depression diagnosis. Logistic regression models were used to assess the association between maternity leave provision and postpartum depression diagnosis adjusting for covariates. RESULTS Overall, 4.8% of the women were diagnosed with postpartum depression. Active duty women who were allotted 12 weeks (2016-2019) of maternity leave had higher odds of postpartum depression diagnosis than those allotted 6 weeks (2011-2015) (12 weeks vs. 6 weeks of leave: odds ratio [OR] = 1.29; 95% confidence interval [CI] = 1.20-1.39, P < 0.0001). However, there was a 50% reduction in odds of postpartum depression during 2016-2017 (the 2 years following the 12-week leave implementation) in comparison to 2011-2015 (OR = 0.50; 95% CI = 0.43-0.57, P < 0.0001). The trends were similar across military branches. Additionally, between 2011 and 2019, the lowest rates of postpartum depression were observed during 2016-2017, but the rates significantly increased starting 2018. Overall, women with lower military ranks had higher postpartum depression rates than those with higher ranks. CONCLUSIONS Our results indicate increasing paid maternity leave in the military from 6 to 12 weeks did initially lower the odds of postpartum depression diagnosis among active duty women from immediately after policy implementation (2016) and prior to the release of the Veterans Affairs and Department of Defense Clinical Practice Guidelines on Pregnancy Management (2018). Later, increased odds of depression (2018-2019) are likely due to increased depression screening protocols at the Military Treatment Facilities in the perinatal period.
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Affiliation(s)
- Minette S R Herrick
- Air Force Institute of Technology PhD Student, Nutrition and Health Sciences, University of Nebraska Lincoln, Lincoln NE 68503, USA
| | - Weiwen Chai
- Nutrition and Health Sciences, University of Nebraska Lincoln, Lincoln NE 68503, USA
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Kaseda ET, Arentoft A, Bangen KJ, Mahmood Z, Thomas K, Kim SH, Tan A, Prieto S, Dawson EL, Riegler K, Sullivan-Baca E, Ellison RL. Parental, caregiving, and family leave during clinical neuropsychology postdoctoral training: Recommendations and guidelines from the Women in Neuropsychology (WIN) committee and Education Advisory Committee (EAC) of the Society for Clinical Neuropsychology (SCN; APA division 40). Clin Neuropsychol 2024; 38:247-261. [PMID: 37270409 DOI: 10.1080/13854046.2023.2217673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/18/2023] [Indexed: 06/04/2023]
Abstract
Objective: Parental and other caregiving leave is important to postdoctoral fellows, yet there is no field-wide recommendation for leave policies among clinical neuropsychology postdoctoral training programs, which is of particular relevance given the two-year requirement for eligibility for board certification. The aims of this manuscript are to (a) discuss general guidelines and recommendations for leave policies, both informed by prior empirical evidence as well as relevant existing policy guidelines from various academic and healthcare organizations, and (b) use vignettes to provide possible solutions for potential leave scenarios. Method: A critical review of literature on family leave from public policy and political science, industrial-organizational psychology, academic medicine, and psychology was conducted and findings were synthesized. Results and Conclusions: Fellowship training programs are encouraged to adopt a competency-based model that permits flexibility in leave during training without necessarily requiring an extended end date. Programs should adopt clear policies and make this information readily available to trainees and think flexibly about training options that best meet the training needs and goals of each individual. We also encourage neuropsychologists at all levels to engage in advocacy for broader systemic supports of trainees seeking equitable family leave.
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Affiliation(s)
- Erin T Kaseda
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Alyssa Arentoft
- Department of Psychology, California State University, Northridge, CA, USA
| | - Katherine J Bangen
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Zanjbeel Mahmood
- Department of Psychology, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, CA, USA
| | - Kelsey Thomas
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Stella H Kim
- McGovern Medical School, Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Alexander Tan
- Department of Neuropsychology, Children's Health Orange County, Orange, CA, USA
| | - Sarah Prieto
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Erica L Dawson
- Department of Neurology, The Ohio State University, Columbus, OH, USA
| | - Kaitlin Riegler
- Pennsylvania State University, University Park, PA, USA
- Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | | | - Rachael L Ellison
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
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Mat Pozian N, Miller YD, Mays J. Family-friendly work conditions and well-being among Malaysian women. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241233113. [PMID: 38426373 PMCID: PMC10908238 DOI: 10.1177/17455057241233113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Although participation in paid work improves women's quality of life and well-being, the health benefits decline for women with young children. Implementing family-friendly work conditions is one strategy for improving working women's well-being, especially those with competing unpaid work responsibilities. OBJECTIVE This study investigated the extent to which accessibility and use of 11 specific family-friendly work conditions were associated with physical health, anxiety and depression in Malaysian women with young children. DESIGN A cross-sectional design using a retrospective self-complete, anonymous, online survey was conducted between March and October 2021. METHODS Women with a child aged 5 years or less (N = 190) completed an online survey measuring their exposure (availability and use) to 11 specific family-friendly work conditions, and their physical health, anxiety, and depression. The sample included women who were currently and recently working and with both formal and informal employment. RESULTS After accounting for potential confounders, women who used paid maternity leave have a lower likelihood of having anxiety symptoms. CONCLUSION Future research is needed to extend the findings from this study by over-sampling women who are informally employed and not currently working. Policy creation and development processes, including research and decision-making, should be led by and inclusive of women. For example, research funding could be allocated to 'lived experience' research that privileges the co-design of research with consumers. Based on these findings, the extent to which family-friendly work conditions fulfill their intent to improve the well-being for working women requires further critique.
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Affiliation(s)
- Nadirah Mat Pozian
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Yvette D Miller
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Jenni Mays
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
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Perry MF, Bui L, Yee LM, Feinglass J. Association Between State Paid Family and Medical Leave and Breastfeeding, Depression, and Postpartum Visits. Obstet Gynecol 2024; 143:14-22. [PMID: 37917931 DOI: 10.1097/aog.0000000000005428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 07/27/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To evaluate the association of state paid family and medical leave policies with the likelihood of breastfeeding, postpartum depression symptoms, and attendance of the postpartum visit. METHODS This was a cross-sectional study that used 2016-2019 data from PRAMS (Pregnancy Risk Assessment Monitoring System) for 43 states and Washington, DC. We describe the association of state paid family and medical leave generosity with rates of breastfeeding, postpartum depression symptoms, and attendance of the postpartum visit. Logistic and Poisson regression models tested the significance of state paid family and medical leave coverage generosity after controlling for individual respondent sociodemographic characteristics, with sensitivity analyses for respondents with deliveries covered by Medicaid insurance. RESULTS Of the 143,131 respondents, representative of an estimated 7,426,725 population, 26.2% lived in eight states and DC with the most generous paid family and medical leave, 20.5% lived in nine states with some paid family and medical leave, and 53.3% lived in 26 states with little or no paid family and medical leave. Overall, 54.8% reported breastfeeding at 6 months or at time of the survey, ranging from 59.5% in the most generous paid family and medical leave states to 51.0% in states with the least paid family and medical leave coverage. Postpartum depression symptoms varied from 11.7% in the most generous states to 13.3% in the least generous states (both P <.001). State differences in postpartum visit attendance rates (90.9% overall) did not differ significantly. After adjusting for respondent characteristics, compared with states with the least paid family and medical leave, breastfeeding was 9% more likely (adjusted incidence rate ratio [aIRR] 1.09, 95% CI, 1.07-1.11) in states with the strongest paid family and medical leave coverage and 32% more likely (aIRR 1.32, 95% CI, 1.25-1.39) in analyses limited to respondents with deliveries covered by Medicaid insurance. A more generous state paid family and medical leave policy was significantly associated with a lower likelihood of postpartum depression symptoms compared with states with the least paid family and medical leave (adjusted odds ratio 0.85, 95% CI, 0.76-0.94) and a modest but significant increase in postpartum visit attendance (aIRR 1.03, 95% CI, 1.01-1.04) among respondents with deliveries covered by Medicaid insurance. CONCLUSION Respondents from states with strong paid family and medical leave had a greater likelihood of breastfeeding and had lower odds of postpartum depression symptoms, with stronger associations among respondents with deliveries covered by Medicaid insurance. Despite major potential health benefits of paid family and medical leave, the United States remains one of the few countries without federally mandated paid parental leave.
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Affiliation(s)
- Madeline F Perry
- Department of Obstetrics and Gynecology, the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois
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Hoang Roberts LN, Zwaans BMM, Vollstedt A, Sharrak A, Han E, Fischer M, Sirls L, Padmanabhan P. Maternity Leave Satisfaction Among Physicians Compared with Nonphysician Professionals. J Womens Health (Larchmt) 2024; 33:33-38. [PMID: 37639698 DOI: 10.1089/jwh.2023.0054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023] Open
Abstract
Objective: The objective of this study was to compare maternity leave satisfaction between physicians and nonphysicians. Currently, paid maternal leave is not guaranteed in the United States, resulting in palpable dissatisfaction among parents. Previous studies have shown associations between length of paid leave and career satisfaction and maternal happiness. Materials and Methods: A Qualtrics® electronic survey was distributed to female professionals through email and social media from April 2019 to March 2020. Inclusion criterion was ≥1 child by birth or adoption, or active pregnancy. Continuous and categorical data were analyzed using two-sample t-test and chi-square, respectively. Results: Of 808 respondents, 77% were physicians. Mean age at birth/adoption of first child was higher in physicians versus nonphysicians (32.1 years vs. 29.7 years; p < 0.001). Physicians took shorter maternity leave than nonphysicians (10.9 weeks vs. 12.0 weeks, p = 0.017) with half of that time paid by employers (5.4 weeks vs. 5.9 weeks, p = 0.2). Dissatisfaction was high among physicians (85.1%) and nonphysicians (92.4%) that correlates with maternity leave compensation dissatisfaction (49% vs. 71.3%, p < 0.001). Thirty-four percent of physicians versus 41% of nonphysicians stated that their health was negatively impacted by maternity leave length. Physicians and nonphysicians reported similar incidences of depression, and breastfeeding, delivery, and other postpartum complications. When queried, 38.8% of physicians and 57% of nonphysicians said they would desire >16 weeks of paid maternity leave (p < 0.001). Conclusions: In conclusion, dissatisfaction among professional women on maternity leave duration and compensation is high in the United States. Given health implications for both mother and child, this should invite further discussion and changes.
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Affiliation(s)
| | - Bernadette M M Zwaans
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Annah Vollstedt
- Department of Urology, University of Iowa, Iowa City, Iowa, USA
| | | | - Esther Han
- Orlando Health Medical Group, Orlando, Florida, USA
| | - Melissa Fischer
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
| | - Larry Sirls
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
| | - Priya Padmanabhan
- Department of Urology, Beaumont Health, Royal Oak, Michigan, USA
- William Beaumont School of Medicine, Rochester, Michigan, USA
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Machen JL, Raaum SE, Patel R, Cioletti A. What to Expect When They're Expecting: Addressing Policy Nuances of Resident Parental Leave. Am J Med 2023; 136:1124-1129. [PMID: 37567377 DOI: 10.1016/j.amjmed.2023.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 08/06/2023] [Indexed: 08/13/2023]
Affiliation(s)
- Julie L Machen
- Department of Internal Medicine, Cone Health Teaching Service, University of North Carolina School of Medicine, Greensboro.
| | - Sonja E Raaum
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City
| | - Rajvi Patel
- Department of Internal Medicine, Dell Medical School at the University of Texas at Austin
| | - Anne Cioletti
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City
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Joshi SS, Kadavath S, Mandoli GE, Gimelli A, Gulati M, Thamman R, Lundberg G, Mehran R, Mulvagh SL, Sade LE, Shivalkar B, Shaw LJ, Hristova K, Dweck MR, Almeida AG, Grapsa J. Women in cardiovascular imaging: a call for action to address ongoing challenges. Eur Heart J Cardiovasc Imaging 2023; 24:1444-1449. [PMID: 37409644 PMCID: PMC10610741 DOI: 10.1093/ehjci/jead158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/17/2023] [Indexed: 07/07/2023] Open
Abstract
AIMS The EACVI Scientific Initiatives Committee and the EACVI women's taskforce conducted a global survey to evaluate the barriers faced by women in cardiovascular imaging (WICVi). METHODS AND RESULTS In a prospective international survey, we assessed the barriers faced at work by WICVi. Three hundred fourteen participants from 53 countries responded. The majority were married (77%) and had children (68%), but most reported no flexibility in their work schedule during their pregnancy or after their maternity leave. More than half of the women reported experiencing unconscious bias (68%), verbal harassment (59%), conscious bias (51%), anxiety (70%), lack of motivation (60%), imposter syndrome (54%), and burnout (61%) at work. Furthermore, one in five respondents had experienced sexual harassment, although this was rarely reported formally. The majority reported availability of mentorship (73%), which was mostly rated as 'good' or 'very good'. While more than two-thirds of respondents (69%) now reported being well trained and qualified to take on leadership roles in their departments, only one-third had been afforded that opportunity. Despite the issues highlighted by this survey, >80% of the participating WICVi would still choose cardiovascular imaging if they could restart their career. CONCLUSION The survey has highlighted important issues faced by WICVi. While progress has been made in areas such as mentorship and training, other issues including bullying, bias, and sexual harassment are still widely prevalent requiring urgent action by the global cardiovascular imaging community to collectively address and resolve these challenges.
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Affiliation(s)
- Shruti S Joshi
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s building, Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Sabeeda Kadavath
- Department of Cardiology, St Bernards Heart and Vascular, Jonesboro, USA
| | | | - Alessia Gimelli
- Department of Imaging, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Martha Gulati
- Department of Cardiology, Cedars-Sinai Heart Institute, Los Angeles, USA
| | - Ritu Thamman
- Department of Cardiology, University of Pittsburgh School of Medicine, Pittsburgh, USA
| | - Gina Lundberg
- Department of Cardiology, Emory Women’s Heart Center, Atlanta, USA
| | - Roxana Mehran
- Department of Cardiology, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Sharon L Mulvagh
- Department of Medicine, Division of Cardiology, Dalhousie University, Halifax, Canada
| | - Leyla Elif Sade
- Department of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, USA
| | - Bharati Shivalkar
- Department of Cardiology, Delta Hospital, Brussels, Belgium
- Pfizer, Luxembourg, Belgium
| | - Leslee J Shaw
- Department of Cardiology, Mount Sinai Medical Center, New York, USA
| | - Krasimira Hristova
- Department of Cardiology, Center for Cardiovascular Disease, SofiaBulgaria
| | - Marc R Dweck
- British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Chancellor’s building, Little France Crescent, Edinburgh, EH16 4SB, UK
| | - Ana G Almeida
- Cardiology Department, University Hospital Santa Maria, Faculty of Medicine of Lisbon University, Lisbon, Portugal
| | - Julia Grapsa
- Department of Cardiology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
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Seo B, Nan H. Major Occupations and Private Insurance of Working Postpartum Women in Poverty in the United States, 2019. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2023; 4:497-505. [PMID: 37908637 PMCID: PMC10615075 DOI: 10.1089/whr.2023.0042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 11/02/2023]
Abstract
Background Although working postpartum women in poverty still have unmet medical needs, relevant research is lacking. Thus, we aimed to determine the five most frequent occupations of U.S. postpartum women in poverty and further examine whether the most frequent occupations are associated with poverty/being uninsured by an employer. Methods This is a cross-sectional study. We included women who had a job and gave birth within the last 12 months from a 2019 American Community Survey Public Use Microdata Sample. To examine the associations between the most frequent occupations and being in poverty/uninsured through an employer/union, we used age- and race-adjusted and multivariable-adjusted logistic regression models. Results A total of 14.3% of working postpartum women lived in poverty, and their most frequent major occupations were sales and related work, followed by food preparation and serving-related work, office and administrative support work, health care support work, and cleaning and ground maintenance. A total of 51.2% of women in the most frequent major occupations were uninsured through an employer/union. Compared with women in other occupations, women in the most frequent major occupations had fewer working hours and weeks that included paid leave. In particular, cleaners and ground maintenance workers and food preparation and serving-related workers were most likely to be in poverty and uninsured through an employer/union. Conclusions Compared with other occupations, the most frequent occupations were more likely to be insecure and less likely to provide health insurance. Our U.S.-based study suggested that current policies regarding employee benefits needed to be improved especially for the most frequent major occupations.
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Affiliation(s)
- Bojung Seo
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
| | - Hongmei Nan
- Department of Epidemiology, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
- Department of Global Health, Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, Indiana, USA
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Bhatia R. Family Leave and Maternal Mortality in the US. JAMA 2023; 330:1387. [PMID: 37815574 DOI: 10.1001/jama.2023.14933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Affiliation(s)
- Richa Bhatia
- Stanford University School of Medicine, Stanford, California
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Schnake-Mahl AS, Pomeranz JL, Sun N, Headen I, O'Leary G, Jahn JL. Forced Birth and No Time off Work: Abortion Access and Paid Family Leave Policies. Am J Prev Med 2023; 65:755-759. [PMID: 37121448 PMCID: PMC10524009 DOI: 10.1016/j.amepre.2023.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 04/25/2023] [Accepted: 04/25/2023] [Indexed: 05/02/2023]
Affiliation(s)
- Alina S Schnake-Mahl
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania.
| | - Jennifer L Pomeranz
- Department of Public Health Policy and Management, School of Global Public Health, New York University, New York, New York
| | - Nina Sun
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Irene Headen
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Gabriella O'Leary
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Thomas Jefferson University Hospitals, Jefferson Health, Philadelphia, Pennsylvania
| | - Jaquelyn L Jahn
- The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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Hidalgo-Padilla L, Toyama M, Zafra-Tanaka JH, Vives A, Diez-Canseco F. Association between maternity leave policies and postpartum depression: a systematic review. Arch Womens Ment Health 2023; 26:571-580. [PMID: 37458837 PMCID: PMC10491689 DOI: 10.1007/s00737-023-01350-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/11/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE Working mothers are at greater risk for postpartum depression. Maternity leave characteristics, including length, wage replacement and employment protection, could have relevant implications for mothers' mental health. We propose to explore whether there is an association between maternity leave characteristics and postpartum depression. METHODS We conducted a systematic review searching for randomized controlled trials, quasi-experimental, cohort or cross-sectional studies on five databases using search terms including maternity and parental leave and depression, as well as references in relevant articles. We identified 500 articles and included 23 of those. We used the EPHPP Quality Assessment Tool for Quantitative Studies to assess the quality of the studies. RESULTS Paid and longer maternity leaves tend to be associated with a reduction of postpartum depression symptoms in high-income countries. No studies explored the association between employment protection and postpartum depression. The quality of studies ranged from strong to weak, mostly influenced by study design. CONCLUSION More restrictive maternity leave policies tend to be associated with higher rates of postpartum depression, although more research needs to be conducted in the Global South.
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Affiliation(s)
- Liliana Hidalgo-Padilla
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Mauricio Toyama
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Alejandra Vives
- Departamento de Salud Pública, y CEDEUS, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
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Chang CY, Liu SR, Glynn LM. One size doesn't fit all: Attitudes towards work modify the relation between parental leave length and postpartum depression. Arch Womens Ment Health 2023:10.1007/s00737-023-01374-5. [PMID: 37737880 DOI: 10.1007/s00737-023-01374-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023]
Abstract
The present study aimed to investigate the relationship between parental leave length and maternal depressive symptoms at six- and twelve-months postpartum and whether this relation was influenced by women's attitudes towards leave, whether leave was paid or unpaid, and the reason they returned to work. The sample included 115 working women recruited during pregnancy as part of a larger longitudinal study. Analyses revealed that maternal attitudes toward leave influenced the association between leave length and depressive symptoms. Specifically, longer leaves were associated with increased depressive symptoms for women who missed their previous activities at work. Furthermore, women who missed work and had leave for 16 weeks or more, exhibited higher depressive symptoms at six- and twelve-months. Last, results also indicated that women who returned to work solely for monetary reasons exhibited more depressive symptoms at six-months postpartum than those who returned to work for other reasons. This study is among the first to show that women's attitudes towards parental leave and their individual reasons for returning to work are important factors to consider that may have potential implications for parental leave policies.
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Affiliation(s)
| | - Sabrina R Liu
- Department of Human Development, California State University, San Marcos, San Marcos, CA, USA
| | - Laura M Glynn
- Department of Psychology, Chapman University, Orange, CA, USA
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Bourque SL, Williams VN, Scott J, Hwang SS. The Role of Distance from Home to Hospital on Parental Experience in the NICU: A Qualitative Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1576. [PMID: 37761537 PMCID: PMC10529472 DOI: 10.3390/children10091576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 09/03/2023] [Accepted: 09/19/2023] [Indexed: 09/29/2023]
Abstract
Prolonged admission to the neonatal intensive care unit presents challenges for families, especially those displaced far from home. Understanding specific barriers to parental engagement in the NICU is key to addressing these challenges with hospital-based interventions. The objective of this qualitative study was to explore the impact of distance from home to hospital on the engagement of parents of very preterm infants (VPT) in the neonatal intensive care unit (NICU). We used a grounded theory approach and conducted 13 qualitative interviews with parents of VPT who were admitted ≥14 days and resided ≥50 miles away using a semi-structured interview guide informed by the socio-ecological framework. We used constant comparative method with double coders for theme emergence. Our results highlight a multitude of facilitators and barriers to engagement. Facilitators included: (1) individual-delivery preparedness and social support; (2) environmental-medical team relationships; and (3) societal-access to perinatal care. Barriers included: (1) individual-transfer stressors, medical needs, mental health, and dependents; (2) environmental-NICU space, communication, and lack of technology; and (3) societal-lack of paid leave. NICU parents with geographic separation from home experienced a multitude of barriers to engagement, many of which could be addressed by hospital-based interventions.
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Affiliation(s)
- Stephanie L. Bourque
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO 80045, USA; (J.S.); (S.S.H.)
| | - Venice N. Williams
- Department of Pediatrics, Prevention Research Center for Family & Child Health, University of Colorado School of Medicine, Aurora, CO 80045, USA;
| | - Jessica Scott
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO 80045, USA; (J.S.); (S.S.H.)
| | - Sunah S. Hwang
- Department of Pediatrics, Section of Neonatology, University of Colorado School of Medicine, Aurora, CO 80045, USA; (J.S.); (S.S.H.)
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Arnautovic TI, Dammann CEL. The neonatal perspective of paid family medical leave (PFML). J Perinatol 2023; 43:1055-1058. [PMID: 35132148 DOI: 10.1038/s41372-021-01300-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 11/16/2021] [Accepted: 12/09/2021] [Indexed: 12/24/2022]
Abstract
Paid family medical leave (PFML) offers infants, parents, and society at large numerous health and economic benefits. It has been shown to improve neonatal and maternal outcomes, breastfeeding rates, familial relationships, and decrease gender inequalities in the workplace. Though the economic feasibility of PFML has been well established in many countries, the USA lacks a cohesive and comprehensive federal PFML policy. Neonatal healthcare providers play a critical role in impacting neonatal health and should actively advocate for the development and promotion of a federal PFML policy, particularly one that is inclusive of both mothers and fathers and is at least 12 weeks in duration.
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Affiliation(s)
- Tamara I Arnautovic
- Division of Newborn Medicine, Department of Pediatrics, Tufts Children's Hospital, Tufts University School of Medicine, Boston, MA, USA.
| | - Christiane E L Dammann
- Division of Newborn Medicine, Department of Pediatrics, Tufts Children's Hospital, Tufts University School of Medicine, Boston, MA, USA
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Marino JA, Meraz K, Dhaliwal M, Payán DD, Wright T, Hahn‐Holbrook J. Impact of the COVID-19 pandemic on infant feeding practices in the United States: Food insecurity, supply shortages and deleterious formula-feeding practices. MATERNAL & CHILD NUTRITION 2023; 19:e13498. [PMID: 36949019 PMCID: PMC10262890 DOI: 10.1111/mcn.13498] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 03/24/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic increased food insecurity among US households, however, little is known about how infants, who rely primarily on human milk and/or infant formula, were impacted. We conducted an online survey with US caregivers of infants under 2 years of age (N = 319) to assess how the COVID-19 pandemic impacted breastfeeding, formula-feeding and household ability to obtain infant-feeding supplies and lactation support (68% mothers; 66% White; 8% living in poverty). We found that 31% of families who used infant formula indicated that they experienced various challenges in obtaining infant formula, citing the following top three reasons: the formula was sold out (20%), they had to travel to multiple stores (21%) or formula was too expensive (8%). In response, 33% of families who used formula reported resorting to deleterious formula-feeding practices such as diluting formula with extra water (11%) or cereal (10%), preparing smaller bottles (8%) or saving leftover mixed bottles for later (11%). Of the families who fed infants human milk, 53% reported feeding changes directly as a result of the pandemic, for example, 46% increased their provisioning of human milk due to perceived benefits for the infant's immune system (37%), ability to work remotely/stay home (31%), concerns about money (9%) or formula shortages (8%). Fifteen percent of families who fed human milk reported that they did not receive the lactation support they needed and 4.8% stopped breastfeeding. To protect infant food and nutrition security, our results underscore the need for policies to support breastfeeding and ensure equitable and reliable access to infant formula.
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Affiliation(s)
| | - Kimberly Meraz
- Department of PsychologyUniversity of CaliforniaMercedCaliforniaUSA
| | - Manuvir Dhaliwal
- Department of PsychologyUniversity of CaliforniaMercedCaliforniaUSA
| | - Denise D. Payán
- Department of Health, Society, and BehaviorUniversity of CaliforniaIrvineCaliforniaUSA
| | - Tashelle Wright
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Jennifer Hahn‐Holbrook
- Department of PsychologyUniversity of CaliforniaMercedCaliforniaUSA
- Health Sciences Research InstituteUniversity of CaliforniaMercedUSA
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Legister CS, Morgan SJ, Samora JB, Weiss JM, Caird MS, Miller DJ. Policies, Practices, and Attitudes Related to Parental Leave for Practicing Pediatric Orthopaedic Surgeons. J Pediatr Orthop 2023; 43:337-342. [PMID: 36827610 DOI: 10.1097/bpo.0000000000002360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
BACKGROUND Parental leave impacts family engagement, bonding, stress, and happiness. Because parental leave benefits are important to all surgeons regardless of sex, understanding parental leave practices in pediatric orthopaedic surgery is critical to promote equity within the profession and supporting balance in work and family life. The aim of this study was to survey pediatric orthopaedic surgeons about their knowledge of parental leave policies, attitudes towards parental leave, and their individual experiences taking leave. METHODS A 34-question anonymous survey was distributed to the Pediatric Orthopaedic Society of North America membership. Eligible respondents were attending pediatric orthopaedic surgeons practicing in the United States or Canada. The survey gathered information about employer parental leave policies, perceptions about and experiences with parental leave while practicing as a surgeon, and demographic information about respondents. RESULTS A total of 77 responses were completed and used for analysis. Most respondents were men (59.7%), <50 years old (67.5%), married (90.9%), and in urban communities (75.3%). A large majority were practicing in the United States (97.4%). Most respondents were unfamiliar with employer parental leave policies (maternity: 53.3%; paternity: 67.5%; and adoption: 85.7%). Those familiar with policies reported that employers offered 7 to 12 weeks for maternity leave (45.7%) and <1 week for paternity leave (50%) and adoption leave (45.5%). Most respondents believed 7 to 12 weeks should be offered for maternity leave (66.2%), 1 to 6 weeks for paternity leave (54.6%), and 7 to 12 weeks for adoption leave (46.8%). Many respondents reported taking 1 to 6 weeks of parental leave as a surgeon (53.3%) and that their colleagues were supportive of their parental leave (40.3%). CONCLUSIONS Most pediatric orthopaedic surgeons were unfamiliar with parental leave benefits provided by employers. Respondents who were familiar with these policies believed that more parental leave should be provided, especially for men who may feel social pressure to take less time for leave. Although respondents reported that their work environments were supportive, this study identified opportunities for improvement to support surgeons who wish to balance parental experiences with work responsibilities. LEVEL OF EVIDENCE Level V.
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Affiliation(s)
| | - Sara J Morgan
- Research Department
- Department of Rehabilitation Medicine
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA
| | - Julie B Samora
- Orthopaedics, Nationwide Children's Hospital, Columbus, OH
| | - Jennifer M Weiss
- Orthopaedics Department, Southern California Permanente Medical Group, Los Angeles, CA
| | - Michelle S Caird
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI
| | - Daniel J Miller
- Department of Orthopaedics, Gillette Children's, St. Paul
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN
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Whitney MD, Holbrook C, Alvarado L, Boyd S. Length of Maternity Leave Impact on Mental and Physical Health of Mothers and Infants, a Systematic Review and Meta-analysis. Matern Child Health J 2023:10.1007/s10995-022-03524-0. [PMID: 37043071 DOI: 10.1007/s10995-022-03524-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2022] [Indexed: 04/13/2023]
Abstract
BACKGROUND Recent legislative decisions in the United States have encouraged discussion about national parental leave programs. Currently, over 47% of the United States workforce is female. However, the United States is the only nation of the 37 member countries in the Organization for Economic Co-Operation and Development (OECD) to have no national requirement for maternity leave. The first few months of a child's life are vital to their physical and mental development. Likewise, a gradual return to pre-partum functioning is important for a newly postpartum woman. While it has been shown that maternity leave positively impacts various measures of maternal and infant mental and physical health, we lack consensus on the optimal length of paid or unpaid maternity leave. Accordingly, we conducted a systematic review and meta-analysis to evaluate the optimal length of paid or unpaid maternity leave to encourage maternal and infant mental and physical health in the United States. METHODS A systematic review and meta-analysis were conducted to synthesize and critically evaluate the current research investigating the association between maternity leave and maternal and infant mental and physical health using the Preferred Reporting in Systematic Reviews and Meta-Analyses guidelines. Databases EMBASE, PsycInfo, and PubMed were searched using specific inclusion and exclusion criteria. Methodological Index for Non-Randomized Studies scale assessed the methodological quality of the included eligible studies. The magnitude of heterogeneity between-study was tested using The Cochrane χ2 test and the Moran's I2 statistic. Possible publication bias was assessed through the funnel plot and the Egger regression test. A p-value of < 0.10 will be considered as an indication for the existence of potential publication bias. All statistical analyses were carried out with Stata software version 15. RESULTS A total of 21 studies were analyzed. It was found that longer maternity leave may decrease rates of maternal mental and physical health complaints. It was also found that longer maternity leave leads to more positive mother-child interactions, decreased infant mortality, and longer periods of breastfeeding. CONCLUSION Maternity leave of 12 weeks or more confers the greatest benefit for mothers and their infants.
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Affiliation(s)
- Madeline Dixon Whitney
- Paul L Foster School of Medicine, El Paso, TX, USA.
- Department of Medical Education, Texas Tech Health Science Center El Paso, 5001 El Paso Drive, El Paso, TX, 79905, USA.
| | | | - Luis Alvarado
- Biostatistics and Epidemiology Consulting Laboratory, El Paso, TX, USA
| | - Sarah Boyd
- Texas Tech El Paso Department of Obstetrics and Gynecology, El Paso, TX, USA
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Noroña-Zhou A, Coccia M, Sullivan A, O’Connor TG, Collett BR, Derefinko K, Renner LM, Loftus CT, Roubinov D, Carroll KN, Nguyen RHN, Karr CJ, Sathyanarayana S, Barrett ES, Mason WA, LeWinn KZ, Bush NR. A Multi-Cohort Examination of the Independent Contributions of Maternal Childhood Adversity and Pregnancy Stressors to the Prediction of Children's Anxiety and Depression. Res Child Adolesc Psychopathol 2023; 51:497-512. [PMID: 36462137 PMCID: PMC10017630 DOI: 10.1007/s10802-022-01002-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2022] [Indexed: 12/05/2022]
Abstract
Women's social experiences can have long-term implications for their offspring's health, but little is known about the potential independent contributions of multiple periods of stress exposures over time. This study examined associations of maternal exposure to adversity in childhood and pregnancy with children's anxiety and depression symptoms in a large, sociodemographically diverse sample. Participants were 1389 mother-child dyads (child age M = 8.83 years; SD = 0.66; 42% Black, 42% White; 6% Hispanic) in the ECHO-PATHWAYS Consortium's three U.S. pregnancy cohorts. Women reported their exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE). Children self-reported on their symptoms of anxiety and depression at age 8-9 years. Regression analyses estimated associations between maternal stressors and children's internalizing problems, adjusting for confounders, and examined child sex as a modifier. Exploratory interaction analyses examined whether geospatially-linked postnatal neighborhood quality buffered effects. In adjusted models, PSLE counts positively predicted levels of children's anxiety and depression symptoms ([ßAnxiety=0.08, 95%CI [0.02, 0.13]; ßDepression=0.09, 95%CI [0.03, 0.14]); no significant associations were observed with CTE. Each additional PSLE increased odds of clinically significant anxiety symptoms by 9% (95%CI [0.02, 0.17]). Neither sex nor neighborhood quality moderated relations. Maternal stressors during pregnancy appear to have associations with middle childhood anxiety and depression across diverse sociodemographic contexts, whereas maternal history of childhood adversity may not. Effects appear comparable for boys and girls. Policies and programs addressing prevention of childhood internalizing symptoms may benefit from considering prenatal origins and the potential two-generation impact of pregnancy stress prevention and intervention.
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Affiliation(s)
- Amanda Noroña-Zhou
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
- Department of Pediatrics, UCSF, San Francisco, CA USA
- Center for Health and Community, UCSF, San Francisco, CA USA
| | - Michael Coccia
- Center for Health and Community, UCSF, San Francisco, CA USA
| | - Alexis Sullivan
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
| | - Thomas G. O’Connor
- Departments of Psychiatry, Psychology, Neuroscience, Department of Obstetrics & Gynecology, University of Rochester, Rochester, NY USA
| | - Brent R. Collett
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle Children’s Research Institute, Seattle, WA USA
| | - Karen Derefinko
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN USA
| | | | - Christine T. Loftus
- Department of Occupational and Environmental Health Sciences, University of Washington, Seattle, WA USA
| | - Danielle Roubinov
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
| | - Kecia N. Carroll
- Departments of Environmental Medicine and Public Health and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - Ruby H. N. Nguyen
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN USA
| | - Catherine J. Karr
- Department of Occupational and Environmental Health Sciences, Department of Pediatrics, University of Washington, Seattle, WA USA
| | - Sheela Sathyanarayana
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle Children’s Research Institute, Seattle, WA USA
| | - Emily S. Barrett
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health; Environmental and Occupational Health Sciences Institute, Rutgers University, New Brunswick, NJ USA
| | - W. Alex Mason
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN USA
| | - Kaja Z. LeWinn
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
| | - Nicole R. Bush
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), San Francisco, CA USA
- Department of Pediatrics, UCSF, San Francisco, CA USA
- Center for Health and Community, UCSF, San Francisco, CA USA
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Neary S, Kamauf R, Ruggeri M. Transparency of Parental Leave Policies to Prospective Students in US Physician Assistant Programs: A Cross-Sectional Study. J Physician Assist Educ 2023; 34:72-75. [PMID: 36652198 DOI: 10.1097/jpa.0000000000000485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
INTRODUCTION Parental leave policies are not well established or always available for prospective graduate students. This study examined the availability and inclusivity of PA program parental leave policies to prospective students at accredited US programs. METHODS The websites and available student handbooks of the 282 currently accredited PA programs were searched for the terms "pregnant," "pregnancy," "maternity," "parent," "family," "child," and/or "birth." Descriptive statistics and Pearson's chi-square test were used to analyze the data. RESULTS In total, 13.5% (38/282) of PA program websites and available handbooks met search criteria. Of these 38 programs, 23 (60.5%) provide information with gendered language that discriminates based on sex, most commonly only mentioning the pregnant female. DISCUSSION PA programs should create specific policies for pregnancy-related and parental leaves that are inclusive to heteronormative families as well as nontraditional and nonnuclear families, and these policies should be widely available to potential applicants and students.
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Affiliation(s)
- Stephanie Neary
- Stephanie Neary, MPA, MMS, PA-C, is an assistant professor adjunct and director of didactic education for the PA Online Program at the Yale School of Medicine in New Haven, Connecticut
- Renée Kamauf, EdD, is Deputy University Registrar at Yale University in New Haven, Connecticut
- Mary Ruggeri, MEd, MMS, PA-C, is clinical site coordinator for the PA Online Program at the Yale School of Medicine in New Haven, Connecticut
| | - Renée Kamauf
- Stephanie Neary, MPA, MMS, PA-C, is an assistant professor adjunct and director of didactic education for the PA Online Program at the Yale School of Medicine in New Haven, Connecticut
- Renée Kamauf, EdD, is Deputy University Registrar at Yale University in New Haven, Connecticut
- Mary Ruggeri, MEd, MMS, PA-C, is clinical site coordinator for the PA Online Program at the Yale School of Medicine in New Haven, Connecticut
| | - Mary Ruggeri
- Stephanie Neary, MPA, MMS, PA-C, is an assistant professor adjunct and director of didactic education for the PA Online Program at the Yale School of Medicine in New Haven, Connecticut
- Renée Kamauf, EdD, is Deputy University Registrar at Yale University in New Haven, Connecticut
- Mary Ruggeri, MEd, MMS, PA-C, is clinical site coordinator for the PA Online Program at the Yale School of Medicine in New Haven, Connecticut
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Nguyen T, Dennison BA, Radigan A, FitzPatrick E, Zhang W, Ncube B. New York State's Paid Family Leave Program is Associated with More Equitable and Increased Use of Paid Leave Following Childbirth. Matern Child Health J 2023; 27:516-526. [PMID: 36609797 PMCID: PMC9992037 DOI: 10.1007/s10995-022-03510-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 01/09/2023]
Abstract
OBJECTIVES This study aimed to assess changes in paid maternity leave before and after New York's (NY) Paid Family Leave (PFL) law went into effect (1/1/2018) and changes in disparities by maternal characteristics. METHODS We used specific data collected on maternity leaves by women who gave birth in 2016-2018 in NY State (outside NY City) participating in the Pregnancy Risk Assessment Monitoring System survey. Multiple logistic regressions were conducted to evaluate the effect of the PFL law on prevalence of paid leave taken by women after childbirth. RESULTS After NY's PFL law went into effect, there was a 26% relative increase in women taking paid leave after childbirth. Use of paid leave after childbirth increased among all racial and ethnic groups. The increases were greater among Black non-Hispanic or other race non-Hispanic women, compared to white non-Hispanic women, suggesting that NY's law was associated with more equitable use of paid leave following childbirth. CONCLUSIONS FOR PRACTICE Wider implementation and greater utilization of paid maternity leave policies would promote health equity and help reduce racial/ethnic disparities in maternal and child health outcomes.
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Affiliation(s)
- Trang Nguyen
- Office of Public Health, New York State Department of Health, Albany, NY, USA. .,Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA.
| | - Barbara A Dennison
- Office of Public Health, New York State Department of Health, Albany, NY, USA.,Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA.,Department of Health Policy, Management and Behavior, University at Albany School of Public Health, Rensselaer, NY, USA
| | - Anne Radigan
- Office of Public Health, New York State Department of Health, Albany, NY, USA
| | | | - Wei Zhang
- Office of Public Health, New York State Department of Health, Albany, NY, USA
| | - Butho Ncube
- Office of Public Health, New York State Department of Health, Albany, NY, USA.,Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, NY, USA
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Heshmati A, Honkaniemi H, Juárez SP. The effect of parental leave on parents' mental health: a systematic review. Lancet Public Health 2023; 8:e57-e75. [PMID: 36603912 DOI: 10.1016/s2468-2667(22)00311-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 11/04/2022] [Accepted: 11/16/2022] [Indexed: 01/05/2023]
Abstract
Mental health disorders during the post-partum period are a common morbidity, but parental leave might help alleviate symptoms by preventing or reducing stress. We aim to summarise available evidence on the effect of different types of parental leave on mental health outcomes among parents. For this systematic review, we searched Ovid MEDLINE, Web of Science, PsycINFO, CINAHL, and Scopus from database inception to Aug 29, 2022, for peer-reviewed, quantitative studies written in English. We included studies if the exposure was postnatal parental leave; a relevant comparison group was present (eg, paid vs unpaid leave); and if indicators related to general mental health, including depression, anxiety, stress, and suicide, for either parent were evaluated or recorded at any time after childbirth. The Review is registered with PROSPERO (registration number CRD42021227499). Of the 3441 records screened, 45 studies were narratively synthesised. Studies were done in high-income countries, and they examined generosity by any parental leave (n=5), benefit amount (n=13), and leave duration (n=31). 38 studies were of medium or high quality. Improved mental health was generally observed among women (referred to as mothers in this Review) with more generous parental leave policies (ie, leave duration and paid vs unpaid leave). For example, increased duration of leave was generally associated with reduced risk of poor maternal mental health, including depressive symptoms, psychological distress and burnout, and lower mental health-care uptake. However, the association between fathers' leave and paternal mental health outcomes was less conclusive as was the indirect effect of parental leave use on partners' mental health.
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Affiliation(s)
- Amy Heshmati
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
| | - Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden
| | - Sol P Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden; Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden
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Kalra K, Delaney TV, Dagi Glass LR. Perceptions of Parental Leave Among Ophthalmologists. JAMA Ophthalmol 2022; 141:24-31. [PMID: 36480180 PMCID: PMC9856738 DOI: 10.1001/jamaophthalmol.2022.5236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Importance Benchmarking attitudes surrounding parental leave among posttraining North American ophthalmologists may reveal possible areas for intervention. Objective To evaluate perceptions of current parental leave policy and culture among posttraining North American ophthalmologists. Design, Setting, and Participants This nonvalidated survey used a 19-item online questionnaire. A convenience sample of 186 self-identified North American-based ophthalmologists who had completed training was obtained using listservs, residency program coordinators, and social media. Data collection occurred from May to July 2022. Main Outcomes and Measures Descriptive analysis demonstrated response frequencies. Pearson χ2 comparison of means was performed for categorical variables. Two-tailed t tests were performed for continuous variables. Results Among the 186 surveys completed, 105 respondents (56.5%) identified as female, 76 (40.9%) worked in academia, 133 (71.5%) were 1 to 20 years out of training, and 156 (83.9%) had children. Attitudes toward stop-the-clock policies, or delays in tenure/promotion/partnership review when taking leave, were mixed. Of 171 respondents, 78 (45.6%) thought that stop-the-clock policies should be optional, 39 (22.8%) thought that they should be required, and 31 (18.1%) thought that they should be removed. Of 76 academicians responding, 56 (73.7%) and 49 (64.5%) were unaware if their institution had a stop-the-clock policy for tenure review or promotion review, respectively. Male and female respondents differed in feeling comfortable with taking leave (36 of 66 [54.5%] vs 67 of 90 [74.4%], respectively; P = .04), as well as in their ratings of stress about peer perception on a scale of 0 to 10 (3.70 vs 4.81, respectively; P = .05). Private practitioners and academicians differed in confirmation of leave options for both parents (52 of 101 [51.5%] vs 49 of 69 [71.0%], respectively; P = .02) and ratings of financial stress (7.10 vs 5.43, respectively; P = .004) and research considerations (1.60 vs 3.85, respectively; P < .001). Conclusions and Relevance Results of this survey study support the hypothesis that demographic factors affect attitudes toward parental leave among posttraining ophthalmologists; policies could be better publicized. Feelings regarding policies and leave were mixed. These findings should be viewed as hypothesis generating because the survey was not validated and the associations provided could be due to confounding factors.
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Affiliation(s)
- Kisha Kalra
- University of Vermont Larner College of Medicine, Burlington
| | - Thomas V. Delaney
- Department of Pediatrics, University of Vermont Larner College of Medicine, Burlington
| | - Lora R. Dagi Glass
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York
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Gough Courtney M, Carroll A. Sex differences in overweight and obesity among Mexican Americans in the National Health and Nutrition Examination Survey: A comparison of measures. SSM Popul Health 2022; 20:101297. [PMID: 36451850 PMCID: PMC9703813 DOI: 10.1016/j.ssmph.2022.101297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/24/2022] Open
Abstract
The increasing prevalence of overweight and obesity in the United States, and disparities by race, ethnicity, and gender, have caused concern among public health practitioners, health care providers, and others, in part because overweight and obesity may be linked to chronic health problems and weight stigma. Researchers have traditionally relied upon body mass index (BMI) as a measure of overweight and obesity, despite its limitations. In this study we apply an intersectional framework and use data from the 2011-2018 waves of the nationally representative National Health and Nutrition Examination Survey (NHANES) to study sex differences in the risk of overweight and obesity among Mexican Americans, triangulating three measures that proxy for overweight and obesity: BMI, high waist circumference, and high percent body fat. We assess heterogeneity across nativity, education, income by parenthood status, food security, time in the United States (for immigrants), and receipt of SNAP/WIC benefits (for the low-income sample). Results from logistic regression models indicate choice of cutoff values and measure are critical to determining whether sex disparities exist. We find no evidence of disparities in BMI but evidence of greater risk for females using traditional cutoff values for high waist circumference and high percent body fat. Adjusted cutoff values provide differing results. Minimal heterogeneity is seen. Results reinforce the importance of considering sex disparities and emphasize the importance of critically examining measures that proxy for overweight and obesity risk, given the high stakes surrounding weight stigma.
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Grant AD, Erickson EN. Birth, love, and fear: Physiological networks from pregnancy to parenthood. COMPREHENSIVE PSYCHONEUROENDOCRINOLOGY 2022; 11:100138. [PMID: 35757173 PMCID: PMC9227990 DOI: 10.1016/j.cpnec.2022.100138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/21/2022] [Accepted: 04/21/2022] [Indexed: 12/01/2022] Open
Abstract
Pregnancy and childbirth are among the most dramatic physiological and emotional transformations of a lifetime. Despite their central importance to human survival, many gaps remain in our understanding of the temporal progression of and mechanisms underlying the transition to new parenthood. The goal of this paper is to outline the physiological and emotional development of the maternal-infant dyad from late pregnancy to the postpartum period, and to provide a framework to investigate this development using non-invasive timeseries. We focus on the interaction among neuroendocrine, emotional, and autonomic outputs in the context of late pregnancy, parturition, and post-partum. We then propose that coupled dynamics in these outputs can be leveraged to map both physiologic and pathologic pregnancy, parturition, and parenthood. This approach could address gaps in our knowledge and enable early detection or prediction of problems, with both personalized depth and broad population scale.
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Affiliation(s)
- Azure D. Grant
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, 94720, United States
- Levels Health Inc., 228 Park Ave. South, PMB 63877, New York, NY, 10003, United States
| | - Elise N. Erickson
- Oregon Health and Science University, Portland, OR, 97239, United States
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McCardel RE, Loedding EH, Padilla HM. Examining the Relationship Between Return to Work After Giving Birth and Maternal Mental Health: A Systematic Review. Matern Child Health J 2022; 26:1917-1943. [PMID: 35907125 DOI: 10.1007/s10995-022-03489-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 10/16/2022]
Abstract
INTRODUCTION The negative impacts of mental health disorders on the well-being of women and their infants are clear. However, less is known about the relationship between returning to work after giving birth and mental health. Previous reviews examined the relationship between maternity leave and mental health, but we defined return to work as the process of returning to part-time or full-time work after giving birth and caring for infant. This systematic review aims to: (1) describe operational definitions for return to work and (2) describe the evidence on the relationship between return to work and maternal mental health. METHODS We searched PubMed, PsycINFO, CINAHL, and Web of Science for peer-reviewed studies. Articles were selected if they were published within the past 20 years, examined at least one mental health condition (e.g., depression, anxiety), and included a study sample of U.S. working mothers. RESULTS We identified 20 articles published between 2001 and 2020. We found conflicting evidence from longitudinal and cross-sectional data demonstrating that return to work was associated with improvements and negative consequences to mental health. Work-related predictors of mental health included: access to paid maternity leave, work-family conflict, total workload, job flexibility, and coworker support. DISCUSSION This review provides evidence that return to work and mental health are related, though the study samples have limited generalizability to all U.S. working mothers. More research is needed to understand the direction of this relationship throughout the perinatal period and how return to work affects other mental health conditions (e.g., anxiety, stress).
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Affiliation(s)
- Rachel Elizabeth McCardel
- Department of Health Promotion and Behavior, University of Georgia, 100 Foster Road, 145 Wright Hall, Athens, GA, 30602, USA.
| | - Emily Hannah Loedding
- Department of Health Promotion and Behavior, University of Georgia, 100 Foster Road, 145 Wright Hall, Athens, GA, 30602, USA
| | - Heather Marie Padilla
- Department of Health Promotion and Behavior, University of Georgia, 100 Foster Road, 145 Wright Hall, Athens, GA, 30602, USA
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Easton V, Silverstein A. Paid Family Leave in Improving Lives of Working Families. J Womens Health (Larchmt) 2022; 31:1069-1070. [PMID: 35776538 DOI: 10.1089/jwh.2022.0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Veronica Easton
- Division of Palliative Care, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Allison Silverstein
- Division of Palliative Care, University of Tennessee Health Science Center, Memphis, Tennessee, USA
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Abstract
Breastfeeding and human milk are the normative standards for infant feeding and nutrition. The short- and long-term medical and neurodevelopmental advantages of breastfeeding make breastfeeding or the provision of human milk a public health imperative. The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond. These recommendations are consistent with those of the World Health Organization (WHO). Medical contraindications to breastfeeding are rare. The AAP recommends that birth hospitals or centers implement maternity care practices shown to improve breastfeeding initiation, duration, and exclusivity. The Centers for Disease Control and Prevention and The Joint Commission monitor breastfeeding practices in United States hospitals. Pediatricians play a critical role in hospitals, their practices, and communities as advocates of breastfeeding and, thus, need to be trained about the benefits of breastfeeding for mothers and children and in managing breastfeeding. Efforts to improve breastfeeding rates must acknowledge existing disparities and the impact of racism in promoting equity in breastfeeding education, support, and services.
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Affiliation(s)
- Joan Younger Meek
- Department of Clinical Sciences, Florida State University College of Medicine, Orlando, Florida
| | - Lawrence Noble
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, Mount Sinai, New York.,New York City Health+Hospitals Elmhurst
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Brito NH, Werchan D, Brandes-Aitken A, Yoshikawa H, Greaves A, Zhang M. Paid maternal leave is associated with infant brain function at 3 months of age. Child Dev 2022; 93:1030-1043. [PMID: 35373346 PMCID: PMC9892990 DOI: 10.1111/cdev.13765] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The first months of life are critical for establishing neural connections relevant for social and cognitive development. Yet, the United States lacks a national policy of paid family leave during this important period of brain development. This study examined associations between paid leave and infant electroencephalography (EEG) at 3 months in a sociodemographically diverse sample of families from New York City (N = 80; 53 males; 48% Latine; data collection occurred 05/2018-12/2019). Variable-centered regression results indicate that paid leave status was related to differences in EEG power (ps < .02, R2 s > .12). Convergent results from person-centered latent profile analyses demonstrate that mothers with paid leave were 7.39 times as likely to have infants with EEG profiles characterized by increased higher-Hz power (95% CI, 1.9-36.9), potentially reflecting more mature patterns of brain activity.
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Affiliation(s)
- Natalie H. Brito
- Department of Applied Psychology, New York University, New York, New York, USA
| | - Denise Werchan
- Department of Population Health, NYU Langone Health, New York, New York, USA
| | | | - Hirokazu Yoshikawa
- Department of Applied Psychology, New York University, New York, New York, USA
| | - Ashley Greaves
- Department of Applied Psychology, New York University, New York, New York, USA
| | - Maggie Zhang
- Department of Applied Psychology, New York University, New York, New York, USA
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Roselin D, Lee J, Jagsi R, Blair-Loy M, Ira K, Dahiya P, Williams J, Mangurian C. Medical Student Parental Leave Policies at U.S. Medical Schools. J Womens Health (Larchmt) 2022; 31:1403-1410. [PMID: 35704286 DOI: 10.1089/jwh.2022.0048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: As medical training occurs during prime childbearing years, parental leave policies may affect the career and family choices of medical students. Materials and Methods: This cross-sectional study builds on existing research by quantifying the prevalence of formal policies for parental leave in highly ranked United States Medical Degree granting institutions, and analyzing the characteristics of those policies, with the objective of identifying existing best practices for future policy adopters to consider. Results: Only 14% of the medical schools reviewed had substantive, stand-alone parental leave policies, and the majority of schools had leave of absence policies without mention of parental leave. Discussion: Leveraging the authors' legal and medical expertise, this analysis highlights existing best practices for medical school leadership to consider, as they examine and develop their policies. Best practices utilized by institutions with the most robust parental policies include adopting a formal and public parental policy, providing a parental enrolled academic adjustment option, guaranteeing approval to take and return from leave/academic adjustment, and continuing health care and financial aid benefits. Given the role of childbearing as a factor associated with gender disparities in academic medicine, and potential impact on racial disparities for students of color, medical school leadership should consider implementation of best practice parental policies to promote equity and wellness of their students. In fact, the deficit of robust parental leave policies in most highly ranked schools may contribute to existing gender and racial disparities in violation with antidiscrimination law. Strengthening policies could increase equity in medical education with positive impacts on the patient population.
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Affiliation(s)
- Danielle Roselin
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), California, USA.,San Francisco Veterans Affairs Medical Center, San Francisco, California, USA
| | - Jessica Lee
- Center for WorkLife Law, Hastings College of the Law, University of California, San Francisco, California, USA
| | - Reshma Jagsi
- Department of Radiation Oncology, Center for Bioethics and Social Sciences in Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Mary Blair-Loy
- Department of Sociology, Center for Research on Gender in STEMM, University of California, San Diego, San Diego, California, USA
| | - Kim Ira
- Center for WorkLife Law, Hastings College of the Law, University of California, San Francisco, California, USA
| | - Priya Dahiya
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco (UCSF), San Francisco, California, USA
| | - Joan Williams
- Center for WorkLife Law, Hastings College of the Law, University of California, San Francisco, California, USA
| | - Christina Mangurian
- Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco (UCSF), California, USA.,San Francisco Veterans Affairs Medical Center, San Francisco, California, USA.,Department of Epidemiology and Biostatistics, Center for Vulnerable Populations, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco (UCSF), San Francisco, California, USA
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Cummins MW, Brannon GE. Mothering in a Pandemic: Navigating Care Work, Intensive Motherhood, and COVID-19. GENDER ISSUES 2022; 39:123-141. [PMID: 35261538 PMCID: PMC8893238 DOI: 10.1007/s12147-022-09295-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
Even before COVID-19, women around the world performed more unpaid domestic labor, specifically unpaid care labor, than men. COVID-19 has only exacerbated the gender gap in this domestic labor. For Western women, especially mothers in the United States of America, the normative discourse of intensive motherhood and the gendered pressure inherent in the unrealistic standards set by the discourse have only increased the amount of unpaid domestic and care labor required of mothers. Using qualitative, in-depth interviews with 18 mothers during May-June 2020, this study examines privileged mothers' perceptions of what they did well in parenting both before and during the early part of the COVID-19 pandemic. The mothers' pragmatic adaptations during the pandemic posed challenges to the norms of intensive motherhood, as did emergent ideas about integrative mothering articulated before the pandemic's onset. We find that while COVID-19 has increased expectations on mothers, it has also provided a turning point wherein expectations can be changed, as the participants suggested. Implications for intensive motherhood scholars, mothers, and communication researchers are discussed, along with future research.
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Affiliation(s)
- Molly Wiant Cummins
- Department of Communication, University of Texas Arlington, Arlington, TX USA
| | - Grace Ellen Brannon
- Department of Communication, University of Texas Arlington, Arlington, TX USA
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WEBSTER JESSICAL, PAUL DAVID, PURTLE JONATHAN, LOCKE ROBERT, GOLDSTEIN NEALD. State-Level Social and Economic Policies and Their Association With Perinatal and Infant Outcomes. Milbank Q 2022; 100:218-260. [PMID: 35128726 PMCID: PMC8932633 DOI: 10.1111/1468-0009.12548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Policy Points State-level social and economic policies that expand tax credits, increase paid parental leave, raise the minimum wage, and increase tobacco taxes have been demonstrated to reduce adverse perinatal and infant health outcomes. These findings can help prioritize evidence-based legislated policies to improve perinatal and infant outcomes in the United States. CONTEXT Rates of preterm birth and infant mortality are alarmingly high in the United States. Legislated efforts may directly or indirectly reduce adverse perinatal and infant outcomes through the enactment of certain economic and social policies. METHODS We conducted a narrative review to summarize the associations between perinatal and infant outcomes and four state-level US policies. We then used a latent profile analysis to create a social and economic policy profile for each state based on the observed policy indicators. FINDINGS Of 27 articles identified, nine focused on tax credits, eight on paid parental leave, four on minimum wages, and six on tobacco taxes. In all but three studies, these policies were associated with improved perinatal or infant outcomes. Thirty-three states had tax credit laws, most commonly the earned income tax credit (n = 28, 56%). Eighteen states had parental leave laws. Two states had minimum wage laws lower than the federal minimum; 14 were equal to the federal minimum; 29 were above the federal minimum; and 5 did not have a state law. The average state tobacco tax was $1.76 (standard deviation = $1.08). The latent profile analysis revealed three policy profiles, with the most expansive policies in Western and Northeastern US states, and the least expansive policies in the US South. CONCLUSIONS State-level social and economic policies have the potential to reduce adverse perinatal and infant health outcomes in the United States. Those states with the least expansive policies should therefore consider enacting these evidence-based policies, as they have shown a demonstratable benefit in other states.
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Affiliation(s)
| | - DAVID PAUL
- ChristianaCare, Department of PediatricsNewarkDE,Thomas Jefferson University Sidney Kimmel College of MedicinePhiladelphia
| | - JONATHAN PURTLE
- Drexel University Dornsife School of Public HealthPhiladelphia
| | - ROBERT LOCKE
- ChristianaCare, Department of PediatricsNewarkDE,Thomas Jefferson University Sidney Kimmel College of MedicinePhiladelphia
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Jang CJ, Lee HC. A Review of Racial Disparities in Infant Mortality in the US. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020257. [PMID: 35204976 PMCID: PMC8870826 DOI: 10.3390/children9020257] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/07/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
Abstract
Racial disparities in infant mortality have persisted, despite the overall decline in the United States’ overall infant mortality rate (IMR). The overall IMR of the entire United States (5.58 per 1000 live births) population masks significant disparities by race and ethnicity: the non-Hispanic Black population experienced an IMR of 10.8 followed by people from Native Hawaiian or Other Pacific Islander populations at 9.4 and American Indians at 8.2. The non-Hispanic White and Asian populations in the United States have the lowest IMR at 4.6 and 3.6, respectively, as of 2018. A variety of factors that characterize minority populations, including experiences of racial discrimination, low income and education levels, poor residential environments, lack of medical insurance, and treatment at low-quality hospitals, demonstrate strong correlations with high infant mortality rates. Identifying, acknowledging, and addressing these disparities must be performed before engaging in strategies to mitigate them. Social determinants of health play a major role in health disparities, including in infant mortality. The study and implementation of programs to address neighborhood factors, education, healthcare access and quality, economic stability, and other personal and societal contexts will help us work towards a common goal of achieving health equity, regardless of racial/ethnic background.
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Affiliation(s)
- Caleb J. Jang
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana-Champaign, IL 61801, USA
- Correspondence: (C.J.J.); (H.C.L.)
| | - Henry C. Lee
- Department of Pediatrics, Stanford University, Stanford, CA 94305, USA
- Correspondence: (C.J.J.); (H.C.L.)
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Carroll G, Vilar-Compte M, Teruel G, Moncada M, Aban-Tamayo D, Werneck H, de Moraes RM, Pérez-Escamilla R. Estimating the costs for implementing a maternity leave cash transfer program for women employed in the informal sector in Brazil and Ghana. Int J Equity Health 2022; 21:20. [PMID: 35151328 PMCID: PMC8841055 DOI: 10.1186/s12939-021-01606-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 12/08/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Maternity leave policies are designed to protect gender equality and the health of mothers in the workforce and their children. However, maternity leave schemes are often linked to jobs in the formal sector economy. In low- and middle-income countries a large share of women work in the informal sector, and are not eligible to such benefit. This is worrisome from a social justice and a policy perspective and suggests the need for intervening. Costing the implementation of potential interventions is needed for facilitating informed decisions by policy makers. METHODS We developed and applied a costing methodology to assess the cost of a maternity leave cash transfer to be operated in the informal sector of the economy in Brazil and Ghana, two countries with very different employment structures and socioeconomic contexts. We conducted sensitivity analysis by modeling different numbers of weeks covered. RESULTS In Brazil, the cost of the maternity cash transfer would be between 0.004% and 0.02% of the GDP, while in Ghana it would range between 0.076% and 0.28% of the GDP. The relative cost of rolling out a maternity intervention in Brazil is between 2.2 to 3.2 times the cost in Ghana depending on the benchmark used to assess the welfare measure. The differences in costs between countries was related to differences in labor market structure as well as demographic characteristics. CONCLUSIONS Findings show how a standard methodology that relies on routinely available information is feasible and could assist policymakers in estimating the costs of supporting a maternity cash transfer for women employed in the informal sector, such intervention is expected to contribute to social justice, gender equity, and health trajectories.
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Affiliation(s)
- Grace Carroll
- Yale School of Public Health, 135 College Street, New Haven, CT, 06510, USA
| | - Mireya Vilar-Compte
- Department of Health, Montclair State University, University Hall 4157, 1 Normal Ave, Montclair, NJ, 07043, USA.
| | - Graciela Teruel
- EQUIDE Research Institute for Equitable Development, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
| | - Meztli Moncada
- EQUIDE Research Institute for Equitable Development, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
| | - David Aban-Tamayo
- EQUIDE Research Institute for Equitable Development, Universidad Iberoamericana, Prolongación Paseo de la Reforma 880, Lomas de Santa Fe, 01219, Mexico City, Mexico
| | - Heitor Werneck
- Brazilian Health Insurance Regulatory Agency (ANS), Av. Augusto Severo, Rio de Janeiro, 84, Brazil
| | - Ricardo Montes de Moraes
- Brazilian Institute of Geography and Statistics (IBGE), Rio de Janeiro, Brazil
- Alberto Coimbra Institute for Graduate Studies and Research in Engineering (COPPE), the Federal University of Rio de Janeiro (UFRJ), Av. Horácio Macedo, 230. Centro de Tecnologia, COPPE/UFRJ, Bloco H, Sala 329. CEP, Rio de Janeiro, RJ, 21941-914, Brazil
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Barnett KS, Banks AR, Morton T, Sander C, Stapleton M, Chisolm DJ. "I just want us to be heard": A qualitative study of perinatal experiences among women of color. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221123439. [PMID: 36168990 PMCID: PMC9523856 DOI: 10.1177/17455057221123439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/23/2022] [Accepted: 08/16/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Long-standing racial disparities, particularly between White and Black women, in maternal and birth outcomes necessitate an examination of the factors influencing these disparities. This study aimed to understand the experiences of women of color as they relate to pregnancy and/or birth complications to inform policy and strategy to decrease racial and ethnic health disparities. METHODS Six focus groups were conducted with women (n = 31) who were identified as a woman of color, were 18 years or older, self-identified as having experienced pregnancy or birth complications after 2016, and who spoke English. A focus group guide co-created with the research team, community partners, and peer researchers from the local community was utilized to elicit discussions related to barriers, successes, and existing opportunities to provide equitable care and services to families throughout the perinatal period. An inductive and iterative approach to qualitative analyses of the focus group transcripts was used to identify key themes. RESULTS The seven themes identified include: lack of knowledge, mental health, communication with providers, support systems, representation, social determinants of health, and discrimination and stigma. Women shared a variety of experiences related to their health care from before pregnancy into their post-partum period, revealing many areas for improvement to extant systems. CONCLUSION The inclusion of voices of the populations most deeply affected by health disparities is crucial to understanding how care and services provided can be improved. This analysis suggests the need for change at multiple levels of the health care and social services systems. These experiences provide valuable insight into some of the many struggles and barriers that women of color face during pregnancy and beyond.
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Affiliation(s)
- Kierra S Barnett
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Ashley R Banks
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Tiffany Morton
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | - Christine Sander
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
| | | | - Deena J Chisolm
- Center for Child Health Equity and Outcomes Research, The Abigail Wexner Research Institute, Nationwide Children’s Hospital, Columbus, OH, USA
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Kraus MB, Reynolds EG, Maloney JA, Buckner-Petty SA, Files JA, Hayes SN, Stonnington CM, Vallow LA, Strand NH. Parental leave policy information during residency interviews. BMC MEDICAL EDUCATION 2021; 21:623. [PMID: 34922524 PMCID: PMC8684616 DOI: 10.1186/s12909-021-03067-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/22/2021] [Indexed: 05/27/2023]
Abstract
BACKGROUND During interviews, medical students may feel uncomfortable asking questions that might be important to them, such as parental leave. Parental leave policies may be difficult for applicants to access without asking the program director or other interviewers. The goal of this study is to evaluate whether parental leave information is presented to prospective residents and whether medical students want this information. METHODS Fifty-two program directors (PD's) at 3 sites of a single institution received a survey in 2019 to identify whether parental leave information is presented at residency interviews. Medical students received a separate survey in 2020 to identify their preferences. Fisher exact tests, Pearson χ2 tests and Cochran-Armitage tests were used where appropriate to assess for differences in responses. RESULTS Of the 52 PD's, 27 responded (52%) and 19 (70%) indicated that information on parental leave was not provided to candidates. The most common reason cited was the belief that the information was not relevant (n = 7; 37%). Of the 373 medical students, 179 responded (48%). Most respondents (92%) wanted parental leave information formally presented, and many anticipated they would feel extremely or somewhat uncomfortable (68%) asking about parental leave. The majority (61%) felt that these policies would impact ranking of programs "somewhat" or "very much." CONCLUSIONS Parental leave policies may not be readily available to interviewees despite strong interest and their impact on ranking of programs by prospective residents.
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Affiliation(s)
- Molly B Kraus
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA.
| | - Emily G Reynolds
- Mayo Clinic Alix School of Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Jillian A Maloney
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
| | - Skye A Buckner-Petty
- Department of Quantitative Health Sciences, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Julia A Files
- Department of Internal Medicine, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Sharonne N Hayes
- Department of Cardiovascular Medicine, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA
| | - Cynthia M Stonnington
- Department of Psychiatry and Psychology, Mayo Clinic, 13400 E Shea Blvd, Scottsdale, AZ, 85259, USA
| | - Laura A Vallow
- Department of Radiation Oncology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Natalie H Strand
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, 5777 E Mayo Blvd, Phoenix, AZ, 85054, USA
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48
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de Souza AC, Carbonera LA, Rocha E. Paid Parental Leave: Different Scenarios Around the World. Stroke 2021; 53:e23-e25. [PMID: 34875843 DOI: 10.1161/strokeaha.121.035919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ana Claudia de Souza
- Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (A.C.d.S., L.A.C.)
| | - Leonardo Augusto Carbonera
- Department of Neurology and Neurosurgery, Hospital Moinhos de Vento, Porto Alegre, Brazil (A.C.d.S., L.A.C.)
| | - Eva Rocha
- Department of Neurology and Neurosurgery (ER), Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil (E.R.)
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Juliebø-Jones P, Pietropaolo A, Spinoit AF, Bergesen AK, Guðbrandsdottir G, Beisland C, von Ostau N, Harke NN, Ribal MJ, Zerva M, Bres-Niewada E, Zondervan P, McLornan L, Ferretti S, Tonnhofer U, Necknig UH, Skolarikos A, Somani BK. Rules and regulations for a pregnant endourologist: the European perspective. World J Urol 2021; 40:857-864. [PMID: 34874462 PMCID: PMC8650738 DOI: 10.1007/s00345-021-03896-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction Working in surgery while pregnant is challenging. Navigating this period safely is of paramount importance. Anecdotal observation suggests that there exists great variation among European nations in regard to maternity leave and radiation safety. The aim of this article was to gain insight into policy patterns and variations across Europe regarding these issues. Methods A series of core question items was distributed to representatives across 12 nations Austria, Belgium, Germany, Greece, Iceland, Italy, Netherlands, Norway, Poland, Republic of Ireland, Spain and the United Kingdom). Results The total number of weeks with full pay ranged from as little as 4 weeks in Belgium to 32 and Iceland. All countries included in this study give the option of additional weeks beyond the initial period, however at reduced pay. Some offer unpaid leave beyond this. Only 5/12 countries had a specific policy on when the pregnant surgeon should come off the on-call rota. Only Austria, Italy and Poland stipulate a requirement for the pregnant clinician to be replaced or be completely exempt in cases involving radiation. Only Germany, Iceland, Norway and Poland highlight the need to limit radiation dose in the first trimester. Beyond this, Germany alone provides written guidance for reduction in gown weight and along with Poland, display arguably the most forward-thinking approach to resting. Conclusion There is a marked range in maternal leave policies across Europe. There also exists a lack of universal guidance on radiation safety for the pregnant urologist. There is urgent need for this void to be addressed.
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Affiliation(s)
- Patrick Juliebø-Jones
- Department of Urology, Haukeland University Hospital, Bergen, Norway. .,Department of Clinical Medicine, University of Bergen, Bergen, Norway. .,Young Academic Urologists (YAU), Urolithiasis & Endourology Working Party, Arnhem, The Netherlands.
| | - Amelia Pietropaolo
- Department of Urology, Ghent University Hospital, Ghent, Belgium.,Young Academic Urologists (YAU), Urolithiasis & Endourology Working Party, Arnhem, The Netherlands
| | | | - Anne K Bergesen
- Department of Urology, Haukeland University Hospital, Bergen, Norway
| | - Gigja Guðbrandsdottir
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Christian Beisland
- Department of Urology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Nicola von Ostau
- Department of Urology, Universitätsklinikum Essen, Essen, Germany
| | - Nina N Harke
- Department of Urology, Universitätsklinikum Essen, Essen, Germany
| | - Maria J Ribal
- Department of Urology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Maria Zerva
- Department of Urology, Red Cross Hospital, Athens, Greece
| | - Ewa Bres-Niewada
- Department of Urology, Roefler Memorial Hospital, Pruszkow, Poland
| | - Patricia Zondervan
- Department of Urology, Amsterdam Medical Centers, Amsterdam, The Netherlands
| | - Liza McLornan
- Department of Urology, Beaumont and Connolly Hospitals, Dublin, Republic of Ireland
| | | | - Ursula Tonnhofer
- Department of Paediatric Surgery, Medical University of Vienna, Vienna, Austria
| | | | - Andreas Skolarikos
- Department of Urology, National and Kapodistrian University of Athens, Athens, Greece
| | - Bhaskar K Somani
- Department of Urology, University Hospital Southampton, Southampton, UK
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Lisboa PC, Miranda RA, Souza LL, Moura EG. Can breastfeeding affect the rest of our life? Neuropharmacology 2021; 200:108821. [PMID: 34610290 DOI: 10.1016/j.neuropharm.2021.108821] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/17/2021] [Accepted: 09/30/2021] [Indexed: 12/31/2022]
Abstract
The breastfeeding period is one of the most important critical windows in our development, since milk, our first food after birth, contains several compounds, such as macronutrients, micronutrients, antibodies, growth factors and hormones that benefit human health. Indeed, nutritional, and environmental alterations during lactation, change the composition of breast milk and induce alterations in the child's development, such as obesity, leading to the metabolic dysfunctions, cardiovascular diseases and neurobehavioral disorders. This review is based on experimental animal models, most of them in rodents, and summarizes the impact of an adequate breast milk supply in view of the developmental origins of health and disease (DOHaD) concept, which has been proposed by researchers in the areas of epidemiology and basic science from around the world. Here, experimental advances in understanding the programming during breastfeeding were compiled with the purpose of generating knowledge about the genesis of chronic noncommunicable diseases and to guide the development of public policies to deal with and prevent the problems arising from this phenomenon. This review article is part of the special issue on "Cross talk between periphery and brain".
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Affiliation(s)
- Patricia C Lisboa
- Laboratory of Endocrine Physiology, Department of Physiological Sciences, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Rosiane A Miranda
- Laboratory of Endocrine Physiology, Department of Physiological Sciences, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Luana L Souza
- Laboratory of Endocrine Physiology, Department of Physiological Sciences, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Egberto G Moura
- Laboratory of Endocrine Physiology, Department of Physiological Sciences, Roberto Alcantara Gomes Biology Institute, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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